The opioid abuse epidemic in the United States was already urgent when the COVID-19 pandemic began, but health authorities fear the virus has made the opioid epidemic even worse.
A Centers for Disease Control and Prevention (CDC) report released in December 2020 notes that 10 western states saw opioid overdoses increase in that year. Most of these deaths – more than 98 percent – are due to opioids such as fentanyl, rather than abuse of more common opioids, such as hydrocodone, the CDC said. The pandemic’s stress and isolation have increased drug use and increasing the chances of an overdose with no one present to render first aid or call for help.
Arizona, California, Colorado, Hawaii, New Mexico, Nevada, Oregon, Utah, and Washington were not known previously for significant levels of fentanyl deaths. Yet starting in 2018, before the pandemic, deaths due to fentanyl began to increase in those western states. The CDC’s data showed that fentanyl deaths in Arizona, California, Colorado, Texas, and Washington rose 371 percent between 2017 and 2019. Post-pandemic, the CDC reported, fentanyl deaths have increased 63 percent over 2019’s already skyrocketing rates in those states.
Michael Barnett is an assistant professor of health policy and management at Harvard University’s T.H. Chan School of Public Health. He thinks 2020 is likely to be the deadliest year on record for opioid overdoses and says there is an urgent need to invest in the country’s mental health infrastructure as one of the approaches to preventing future substance abuse.
“The COVID-19 pandemic in the U.S. isn’t just about COVID-19, it’s about managing all of the spillover effects, including the effects it has had on people with addiction and substance use disorder,” Barnett says. “There is compelling initial data — and more is going to come out — indicating that 2020 will be the worst year for opioid overdoses that we’ve ever had. It unfortunately looks like we have lost a lot of progress we had made on opioid overdoses in recent years because of the pandemic.”
One of the reasons for this loss of progress is because the pandemic took the attention of the media, legislators, and public health agencies that were previously focused on the opioid crisis, he says.
One potential part of the solution, he says, is getting rid of the so-called “X waiver,” which is a requirement that physicians must have a special waiver from the federal Food and Drug Administration (FDA) to legally prescribe buprenorphine, a medication used to treat opioid use disorder. “It’s an anachronistic and backward policy that has caused a lot of harm and is no longer relevant in 2020,” Barnett says. “That policy has actually been temporarily waived under an emergency declaration from the Department of Health and Human Services as of last month, which is a very big change. But is there going to be momentum to maintain that change?”
Barnett said he also thinks that financial settlements against opioid manufacturers should be invested in mental health infrastructure. “We need to provide resources for primary care clinics to enhance their behavioral health support. We need resources to enhance local counseling services,” he said. “We need to help health care organizations provide easy access to mental health care because everyone needs it right now. Every community in the U.S. needs this type of support.”
Men’s Health Network (MHN) is a non-profit organization headquartered in Washington, D.C. For more than 25 years, it has advocated for health and social action on issues that affect men and boys. MHN and the Congressional Men’s Health Caucus co-hosted a briefing, “Men’s and Boys’ Mental Health Issues: Gateways to Opioid and Drug Abuse” in 2018. The issues raised in that briefing remain relevant today. (See the presentation at https://tinyurl.com/856ul7xx).
That same year, the Patient-Centered Outcomes Research Institute (PCORI) launched an initiative called Psychosocial Interventions with Office-Based Opioid Treatment.” Among the research projects the initiative has funded is a study examining a counseling program for people who support patients with Opioid Use Disorder (OUD).
In the study, Karen Osilla, Ph.D., of RAND Corporation, will test a counseling program for people with family members, spouses or friends who have OUD. It will teach support people effective ways to help a person with OUD change their behavior. (Read more about the study here: https://tinyurl.com/trbmq8te).
